Predictors of Hospital Readmissions within 30 Days after Discharge

1WFUHS, Winston Salem, NC
2WFUHS, Winston Salem, NC
3WFUHS, Winston Salem, NC
4WFUHS, Winston Salem, NC
5WFUHS, Winston Salem, NC
6WFUHS, Winston Salem, NC
7WFUHS, Winston Salem, NC

Meeting: Hospital Medicine 2010, April 8-11, Washington, D.C.

Abstract number: 70

Background:

Read mission to the hospital soon after discharge is a significant burden to patients and our health care system, We aimed to study the predictors of readmissions within 30 days of discharge from our hospitalist service in 1 year.

Methods:

All readmissions within 3D days of discharge from hospitalist service in 2007 were identified from the University Health Consortium database. DRG‐matched, age‐matched control data (patients who were not readmitted within 30 days) were identified from all admissions to hospitalist service in 2007. Individual chart review was performed on readmits and control data manually by 6 physicians. Read missions to any service in the hospital were included and planned readmissions excluded in the analysis.

Results:

A total of 145 age‐ and DRC‐matched readmissions and controls were included in the final analysis. When compared to control data, univariate analysis showed that Die readmitted patients had a higher incidence of heart failure (14% vs. 21%, P = 0.01), end‐stage renal disease (10% vs. 18%, P = 0.05), chronic decubitus (2% vs. 10%, P = 0.006), and history of noncompltanoe (23% vs. 37%, P = 0.009). The mean number of years of hospitalist experience was less in the readmitted group com pa red with controls (3.2 ± 1.6 vs. 2,8 ± 1,5. P = 0.03}. The average length of stay was higher for the read mitted patients compared with controls (6,2 ± 5.S vs, 4,6 ± 4.S, P = 0.03), Patients discharged to a nursing facility/assisted living facility had higher incidence of read‐missions compared with control data (19% vs. 7%, P = 0005), and patients who had newer medication introduced (including optimization of medication regimen) were less likely to be readmitted (15% vs. 29%, P = 0.006). The 2 groups did not differ in sex, race, diabetes, hypertension, chronic obstructive lung disease, dementia, stroke, severity of illness, substance abuse, and prescription drug abuse. Multiple regression analysis showed that hospitalist experience of less than 2 years (OR 2.1,95% Cl 1.03‐4.4. P=0.04). history of noncompliance (OR 4.9,95% Cl 22‐11.1. P=0.04). and discharging to a skilled nursing facility (OR 5,6, 95% Cl 1.9‐17.4, P = 0.002) were the final independent predictors of read mission after adjusting forcomorbidities.

Conclusions:

Our study found that history of noncompliance, hospitalist experience of less than 2 years, and discharge to nursing facilities to be independent predictors of hospital readmission within 30 days of discharge, even after adjusting for underlying comorbidities. A multilevel intervention process including education of physicians, patients and communication with nursing home health care providers is needed to prevent and/or decrease readmissions.

Author Disclosure:

V. Jeevanantham, none; G. Jao, none; R. Vadlamudi, none; P. Vasireddy, none; G. Russell, none; S. Stefanescu, none; P. Agborbesong, none.

To cite this abstract:

Jeevanantham V, Jao G, Vadlamudi R, Vasireddy P, Russell G, Stefenescu S, Agborbesong P. Predictors of Hospital Readmissions within 30 Days after Discharge. Abstract published at Hospital Medicine 2010, April 8-11, Washington, D.C. Abstract 70. Journal of Hospital Medicine. 2010; 5 (suppl 1). https://www.shmabstracts.com/abstract/predictors-of-hospital-readmissions-within-30-days-after-discharge/. Accessed September 18, 2019.

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